Alimentary tract: neoplasia

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Sections available in full article Introduction, Presenting signs, Acute presentation, Geographic incidence, Age predisposition, Sex predisposition, Breed predisposition, Pathogenesis, Predisposing factors, Diagnosis, Presenting problems, Client history, Clinical signs, Diagnostic investigation, Gross autopsy findings, Histopathology findings, Differential diagnosis, Treatment, Initial symptomatic treatment, Standard treatment, Monitoring, Subsequent management, Sequelae, Prognosis, Expected response to treatment, Reasons for treatment failure, Sources, Publications, Vetstream contributor(s),
Contributors Dr Laura Garrett DVM DACVIM (Oncology)
Dr Philip K Nicholls BVSc BSc PhD MRCVS FRCPath
Synonyms GI lymphoma, adenocarcinoma, mast cell tumor

Introduction

  • The stomach and the large intestine (LI)  Large intestine: neoplasia  are rare sites for neoplasia in cats; the small intestine (SI)  Small intestine: neoplasia  is the most common site to be affected in the alimentary tract. 
  • Lymphoma  Lymphoma   is the most common tumor, with adenocarcinoma  Adenoma adenocarcinoma   the second most common. Oral cavity tumors (squamous cell carcinoma  Mouth: squamous cell carcinoma   especially, fibrosarcoma  Fibrosarcoma   less so) are moderately common in cats. Esophageal carcinoma  Esophagus: neoplasia   is uncommon. Various rare tumors include oral fibropapilloma, ganglioneuroma, carcinoid tumors, liposarcoma, granular cell tumors, and feline inductive odontogenic tumor.

Diagnosis

Clinical signs

  • See Presenting problems.

Diagnosis

Differential diagnosis

  • Differentials for the clinical signs in these older cats would include metabolic disease such as chronic renal failure  Kidney: chronic kidney disease   and non-neoplastic GI disease such as inflammatory bowel disease  Inflammatory bowel disease: overview  .
  • Depending on the geographic location, thickened GI loops with lymphadenopathy may be due to histoplasmosis  Histoplasmosis  .
  • Non-neoplastic differentials if a mass lesion is palpated would include a foreign body obstruction  Stomach: gastric foreign body     Intestine: foreign body - linear     Intestine: obstruction  , intussusception  Intussusception  , or a granuloma.
  • Benign polyps in the stomach, duodenum, and colon are rarely reported in cats.

Sequelae

Prognosis

  • See response to treatment.

Expected response to treatment

  • Only approximately one out of three cats with GI LSA  Lymphoma   respond to chemotherapy.  The median survival is one year; however, some of the responders may live for many years.  There is no good predictor of whether an individual cat will respond other than the actual response to therapy.  If no response is seen after one cycle of drugs, the prognosis is very poor.
  • Cats with adenocarcinoma  Adenoma adenocarcinoma   have a median reported survival time ranging from 6-15 months, depending on the study, with some cats living greater than 4 years.  Even cats with mesenteric LN metastasis had a median survival of 12 months; thus the finding of metastatic disease in these cats should not preclude surgical intervention.  The benefits of chemotherapy post-operatively has not been investigated.
  • Intestinal MCT  Mastocytoma   in cats carries a grave prognosis as it is often a fairly diffuse, non-surgical condition that does not respond well to chemotherapy.  Reported survival time in a small number of cats treated with surgery was around 4 months.

Reasons for treatment failure

  • Chemotherapy resistance with LSA and MCT, metastasis with adenocarcinoma.
  • FeLV positive cats may have shorter remission and survival times after chemotherapy for alimentary lymphoma.

Sources

Publications

Refereed papers

  • Patterson-Kane J C, Kugler B P & Francis K (2004)The possible prognostic significance of immunophenotype in feline alimentary lymphoma: a pilot study.Vet Pathol130, 220-222 PubMed.
  • Sato A F & SolanoM (2004)Ultrasonographic findings in abdominal mast cell disease: a retrospective study of 19 patients.Vet Radiol Ultrasound45(1), 51-57 PubMed.
  • Carreras J K, Goldschmidt M, Lamb M, McLear R C, Drobatz K J & Sorenmo K U (2003)Feline epitheliotropic intestinal malignant lymphoma: 10 cases (1997-2000).J Vet Intern Med17, 326-331 PubMed.
  • Teske E, van Straten G et al(2002)Chemotherapy with cyclophosphamide, vincristine, and prednisolone (COP) in cats with malignant lymphoma: new results with an old protocol.J Vet Intern Med16(2), 179-186 PubMed.
  • Peaston A E & Maddison J E (1999)Efficacy of doxorubicin as an induction agent for cats with lymphosarcoma.Aust Vet J77(7), 442-444 PubMed.
  • Vail D M, Moore A S et al(1998)Feline lymphoma (145 cases): proliferation indices, cluster of differentiation 3 immunoreactivity, and their association with prognosis in 90 cats.J Vet Intern Med12(5), 349-354.
  • Zwahlen C H, Lucroy M D et al(1998)Results of chemotherapy for cats with alimentary malignant lymphoma: 21 cases (1993-1997).J Am Vet Med Assoc213(8),1144-1149.
  • Rivers B J & Walter P Aet al(1997)Ultrasonographic features of intestinal adenocarcinoma in five cats.Vet Radiol Ultrasound38(4), 300-306.
  • Slawienski M J, Mauldin G Eet al(1997)Malignant colonic neoplasia in cats: 46 cases (1990-1996).J Am Vet Med Assoc211(7), 878-881.
  • Gardner D G & Dubielzig R R (1995)Feline inductive odontogenic tumour (feline inductor fibroameloblastoma) a tumor unique to cats.J Oral Pathol24,185-190.
  • Mahony O M, Moore A Set al(1995)Alimentary lymphoma in cats: 28 cases (1988-1993).J Am Vet Med Assoc207(12), 1593-1598.
  • Kosovsky J E, Matthiesen D Tet al(1988)Small intestinal adenocarcinoma in cats: 32 cases (1978-1985).J Am Vet Med Assoc192(2), 233-235.

Other sources of information

  • Meuten D J (2001)Tumors in Domestic Animals.4th edn. Iowa State Press.
  • Withrow & MacEwen (2001) Small Animal Clinical Oncology.3rd edn. Saunders.

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